2005, Número 2
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salud publica mex 2005; 47 (2)
Inmunogenicidad y tolerancia de una vacuna contra influenza, en una población mexicana mayor de 55 años de edad
Ayala-Montiel O, Mascareñas C, García-Hernández D, Rendón-Muñiz J, López I, Montaño LF, Zenteno I, Franco-Paredes C
Idioma: Español
Referencias bibliográficas: 46
Paginas: 155-162
Archivo PDF: 101.71 Kb.
RESUMEN
Objetivos. Verificar la inmunogenicidad y tolerancia de una vacuna purificada, inactivada y fraccionada contra influenza, en adultos mexicanos derechohabientes de Petróleos Mexicanos (Pemex).
Material y métodos. Se incluyeron 90 adultos mayores de 55 años de edad, derechohabientes de los servicios médicos del Hospital Central Sur Pemex, durante los meses de noviembre y diciembre de 2000. Los criterios evaluados en relación con la inmunogenicidad incluyeron el porcentaje de sujetos protegidos, cuantificados por medio de anticuerpos antihemaglutininas superior o igual a 1:40, así como por el porcentaje de seroconversión determinado por el título inicial de anticuerpos multiplicado por un factor 4X. Los criterios secundarios fueron la frecuencia
de reacciones adversas tanto locales como sistémicas.
Se realizaron estudios de afinidad antígeno-anticuerpo
para determinar la respuesta policlonal de anticuerpos y de
anticuerpos de alta afinidad prevacunación y posvacunación.
Se calcularon frecuencias y porcentajes.
Resultados. Se identificó una seroprotección en 95.6% de los sujetos a la cepa H1N1, de 98.9% a la cepa H3N2 y de 100% a la cepa B/
Yamanashi. En cuanto a los porcentajes de seroconversión,
se identificó un incremento 4X de 74.4 para la cepa H1N1,
de 88.9 para la cepa H3N2, y de 82.2 para la cepa B / Yamanashi. Un total de 18 individuos (20%) presentaron reacciones locales, mientras que 17 (18.8%) presentaron reacciones sistémicas a los cinco días posvacunación y nueve sujetos (10%) a los 28 días. Las reacciones locales a los cinco días consistieron en dolor, en 10 individuos (11.1%); enrojecimiento, en ocho (8.8%), e induración, en seis (6.6%). Malestar general, cefalea y fiebre se presentaron a los cinco días en 10, 8.8, y 0% de individuos, respectivamente, y en 4.4, 6.6, y 0%, respectivamente, a los 28 días.
Conclusiones. Esta vacuna contra influenza demostró ser altamente inmunogénica en adultos mexicanos mayores de 55 años de edad. Se demostró también la producción de anticuerpos de alta afinidad contra el virus, posterior a la vacunación. Además, se identificó una frecuencia de reacciones locales y sistémicas similares a las previamente reportadas. Estos resultados pueden ser extensivos a instituciones de salud que atienden principalmente a adultos mayores de 55 años de edad, para incrementar las tasas anuales de cobertura de vacunación contra influenza.
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